Assessment of sexual dysfunction in patients with perianal Crohn's disease

• Published in: Colorectal disease Vol. 23; no. 1; pp. 114 - 122
• Main Authors: Boudiaf, R., Bouchard, D., Rivière, P., Brochard, C., Laharie, D., Abramowitz, L., Pigot, F.
• Format: Journal Article
• Language: English
• Published: England Wiley Subscription Services, Inc 01-01-2021
• Subjects: Crohn Disease - complications; Crohn Disease - epidemiology; Crohn's disease; Crohns disease; Erectile dysfunction; Erectile Dysfunction - epidemiology; Erectile Dysfunction - etiology; Female; Humans; Inflammatory bowel disease; Male; Multivariate analysis; Perineum; Population studies; Prevalence; proctology; Sexual Behavior; sexual dysfunction; Sexual Dysfunction, Physiological - epidemiology; Sexual Dysfunction, Physiological - etiology; Sexuality; Stenosis; Inflammatory bowel disease; proctology; sexual dysfunction
• ISSN: 1462-8910; 1463-1318
• DOI: 10.1111/codi.15375

Aim
Over the past 10 years, several studies have focused on sexuality in patients with Crohn's disease. Very few of them specifically focused on perianal disease (PD). This study aimed to compare the prevalence of sexual dysfunction (SD) in Crohn's disease patients with active PD versus controls without active PD.
Method
Patients from 14 French centres with active PD, defined by the presence of symptomatic ulceration, fistula or stenosis, were arbitrarily included. They were compared with controls from the existing SEXIA cohort. Men completed the International Index of Erectile Function (IIEF) and women the Female Sexual Function Index (FSFI). The primary end‐point was SD defined by FSFI < 26.55 in women and IIEF < 42.9 in men.
Results
Ninety‐seven patients (64 women, 33 men) and 238 controls (131 women, 107 men) were included. SD was found in 66% of the female patients versus 50% of the controls (P = 0.04). In the male population, SD was found in 30% of the cases versus 16% of the controls (P = 0.06). Erectile dysfunction affected 46% of the male patients and 43% of the controls (P = 0.8). On multivariate analysis, the predictive factor most strongly associated with SD in women was severely active anal PD defined by a perineal disease activity index > 4 [OR = 13.05 (2.32–73.44)].
Conclusion
Women with active PD had an increased prevalence of SD compared with controls without active PD. In the male population, the study was unable to determine whether there was a difference as it was underpowered.